How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,380 · 10th to 90th $1,175 to $3,715
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,071.52 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,230.27 | $1,995.26 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,949.84 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $4,073.80 | Professional | None | $1,288.25 | $1,380.38 | $4,073.80 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $6,165.95 | Professional | None | $1,096.48 | $1,445.44 | $6,165.95 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $977.24 |
Where New Jersey sits
The same service costs 8.5 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $16,489MD $1,943
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.